Pain Relief Through Photography
Can looking at the photograph of a loved one make pain go away?
Numerous studies show that strong social connections have benefits for health. People who have active social lives seem to live longer than those who are isolated, and married cancer patients have a better outlook than divorced cancer patients. Now, a study [pdf] suggests that merely looking at a photograph of a loved one can relieve the sensation of physical pain.
Psychologists at the University of California, Los Angeles, recruited 25 women who had steady boyfriends. Using a tool that applied heat to the women’s forearms, they turned up the temperature until it was slightly uncomfortable and asked the women to rate the pain they experienced on a scale of one to 20.
The researchers manipulated the heat and recorded the women’s reactions under different conditions: while she was looking at a photo of her boyfriend, or a photo of a complete stranger and a chair. They also had the women rate the pain while they held the hand of a stranger hidden behind a curtain, and as they held their boyfriend’s hand or a squeeze ball.
“We saw lower pain ratings on average when the women were holding their partner’s hand compared with a stranger’s hand or an object,” said Sarah L. Master, the lead author of the paper, who did the study at U.C.L.A. as part of her doctoral research.
When the women looked at photographs of their boyfriends, they rated the pain lower than when they were staring at a photo of a stranger or a chair. Surprisingly, they even ranked the pain lower than they had while holding their boyfriend’s hand.
“It’s interesting that a physical sensation can actually become more manageable by just looking at a photo of someone you find supportive,” Dr. Master said. The study appeared in the November issue of the journal Psychological Science.
Under certain circumstances, Dr. Master suggested, looking at a photo may have an even stronger effect than having the person physically present. “Having the actual person there might not be a good thing if the person is in a bad mood or not being supportive at that moment. A picture could be a better solution,” she said.
Dr. Master said the mere reminder of the loved one may engender feelings of support, possibly by prompting the release of endogenous opioids, chemicals in the brain that have pain relief effects.
Monday, January 23, 2012
Really? The Claim: Yoga Can Help Manage Pain
Really? The Claim: Yoga Can Help Manage Pain
THE FACTS
For many people, yoga is more than just exercise: Studies show it is one of the most commonly used forms of alternative therapy in the country. Many rely on yoga to relieve chronic and acute pain.
The reasons for this are varied. Some researchers believe that yoga may alleviate pain through relaxation and the release of endorphins. Others say it may reduce inflammation and promote positive emotions.
Plenty of studies have tried to determine whether taking up yoga can actually help lessen pain. In a recent report, a team of researchers sifted through the science and identified 10 randomized clinical trials on the subject involving hundreds of patients.
The studies looked at yoga’s effect on pain stemming from ailments like arthritis, low back problems, pregnancy symptoms and migraines. The control conditions were standard treatments and exercise, diet and lifestyle changes.
Nine out of the 10 clinical trials found yoga could help provide relief from pain, which the authors called “encouraging.” But they also noted that no definitive conclusion could be reached, for a number of reasons.
The studies involved patients experiencing pain from a wide variety of conditions, and they looked at several types of yoga that had some similarities, like breathing, stretching and relaxation exercises — but also many differences. Complicating matters was that the intensity, amount of time and frequency of the yoga sessions differed from one study to the next.
While the evidence suggests that yoga has the potential to alleviate pain, they wrote, the science is not firm enough to say for certain.
THE FACTS
For many people, yoga is more than just exercise: Studies show it is one of the most commonly used forms of alternative therapy in the country. Many rely on yoga to relieve chronic and acute pain.
The reasons for this are varied. Some researchers believe that yoga may alleviate pain through relaxation and the release of endorphins. Others say it may reduce inflammation and promote positive emotions.
Plenty of studies have tried to determine whether taking up yoga can actually help lessen pain. In a recent report, a team of researchers sifted through the science and identified 10 randomized clinical trials on the subject involving hundreds of patients.
The studies looked at yoga’s effect on pain stemming from ailments like arthritis, low back problems, pregnancy symptoms and migraines. The control conditions were standard treatments and exercise, diet and lifestyle changes.
Nine out of the 10 clinical trials found yoga could help provide relief from pain, which the authors called “encouraging.” But they also noted that no definitive conclusion could be reached, for a number of reasons.
The studies involved patients experiencing pain from a wide variety of conditions, and they looked at several types of yoga that had some similarities, like breathing, stretching and relaxation exercises — but also many differences. Complicating matters was that the intensity, amount of time and frequency of the yoga sessions differed from one study to the next.
While the evidence suggests that yoga has the potential to alleviate pain, they wrote, the science is not firm enough to say for certain.
Giving Chronic Pain a Medical Platform of Its Own
Giving Chronic Pain a Medical Platform of Its Own
Most doctors view pain as a symptom of an underlying problem — treat the disease or the injury, and the pain goes away.
But for large numbers of patients, the pain never goes away. In a sweeping review issued last month, the Institute of Medicine — the medical branch of the National Academy of Sciences — estimated that chronic pain afflicts 116 million Americans, far more than previously believed.
The toll documented in the report is staggering. Childbirth, for example, is a common source of chronic pain: The institute found that 18 percent of women who have Caesarean deliveries and 10 percent who have vaginal deliveries report still being in pain a year later.
Ten percent to 50 percent of surgical patients who have pain after surgery go on to develop chronic pain, depending on the procedure, and for as many as 10 percent of those patients, the chronic postoperative pain is severe. (About 1 in 4 Americans suffer from frequent lower back pain.)
The risk of suicide is high among chronic pain patients. Two studies found that about 5 percent of those with musculoskeletal pain had tried to kill themselves; among patients with chronic abdominal pain, the number was 14 percent.
“Before, we didn’t have good data on what is the burden of pain in our society,” said Dr. Sean Mackey, chief of pain management at the Stanford School of Medicine and a member of the committee that produced the report. “The number of people is more than diabetes, heart disease and cancer combined.”
For patients, acknowledgment of the problem from the prestigious Institute of Medicine is a seminal event. Chronic pain often goes untreated because most doctors haven’t been trained to understand it. And it is isolating: Family members and friends may lose patience with the constant complaints of pain sufferers. Doctors tend to throw up their hands, referring patients for psychotherapy or dismissing them as drug seekers trying to get opioids.
“Most people with chronic pain are still being treated as if pain is a symptom of an underlying problem,” said Melanie Thernstrom, a chronic pain sufferer from Vancouver, Wash., who wrote “The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing and the Science of Suffering” (Farrar, Straus & Giroux, 2010) and was a patient representative on the committee.
“If the doctor can’t figure out what the underlying problem is,” she went on, “then the pain is not treated, it’s dismissed and the patient falls down the rabbit hole.”
Among the important findings in the Institute of Medicine report is that chronic pain often outlasts the original illness or injury, causing changes in the nervous system that worsen over time. Doctors often cannot find an underlying cause because there isn’t one. Chronic pain becomes its own disease.
“When pain becomes chronic, when it becomes persistent even after the tissue and injury have healed, then people are suffering from chronic pain,” Dr. Mackey said. “We’re finding that there are significant changes in the central nervous system and spinal cord that cause pain to become amplified and persistent even after the injury has gone away.”
The institute emphasized the importance of prevention and early treatment, a novel concept for many doctors who try to diagnose the source of pain before treating it or advise patients to wait it out in the hope it will go away on its own.
“Having pain that is not treated is like having diabetes that’s not treated,” said Ms. Thernstrom, who suffers from spinal stenosis and a form of arthritis in the neck. “It gets worse over time.”
Ms. Thernstrom compared the effect of chronic pain on the body to the rushing waters of a river carving out a new tributary. Pain, she says, also changes the body’s landscape.
“My pain is at the level where it’s manageable,” she said. “I do wish I had gotten aggressive treatment in the first year. There is a window of time to intervene, because pain changes your nervous system and pain pathways develop.”
The report also acknowledged the “conundrum of opioids,” noting that doctors are conflicted about how to treat pain because of worries about drug addiction. But the group noted that proper use of the drugs early in a pain cycle can resolve pain problems sooner, and stated that opioids are also particularly useful for pain management near the end of life.
The pain report is only a first step for the community of medical professionals who treat pain. It will be up to medical schools to begin better education of doctors in the treatment of pain, and the National Institutes of Health to decide whether to promote research into chronic pain. Patients, too, need to be educated about the importance of early treatment of pain rather than gutting it out or waiting until it has become severe and chronic.
“Some people were expecting a cure within the report,” Dr. Mackey said. “There’s no immediate cure. But I’ve seen a lot of patients who have said, ‘Finally they are putting out a report that helps others understand what I’m going through.’ ”
Most doctors view pain as a symptom of an underlying problem — treat the disease or the injury, and the pain goes away.
But for large numbers of patients, the pain never goes away. In a sweeping review issued last month, the Institute of Medicine — the medical branch of the National Academy of Sciences — estimated that chronic pain afflicts 116 million Americans, far more than previously believed.
The toll documented in the report is staggering. Childbirth, for example, is a common source of chronic pain: The institute found that 18 percent of women who have Caesarean deliveries and 10 percent who have vaginal deliveries report still being in pain a year later.
Ten percent to 50 percent of surgical patients who have pain after surgery go on to develop chronic pain, depending on the procedure, and for as many as 10 percent of those patients, the chronic postoperative pain is severe. (About 1 in 4 Americans suffer from frequent lower back pain.)
The risk of suicide is high among chronic pain patients. Two studies found that about 5 percent of those with musculoskeletal pain had tried to kill themselves; among patients with chronic abdominal pain, the number was 14 percent.
“Before, we didn’t have good data on what is the burden of pain in our society,” said Dr. Sean Mackey, chief of pain management at the Stanford School of Medicine and a member of the committee that produced the report. “The number of people is more than diabetes, heart disease and cancer combined.”
For patients, acknowledgment of the problem from the prestigious Institute of Medicine is a seminal event. Chronic pain often goes untreated because most doctors haven’t been trained to understand it. And it is isolating: Family members and friends may lose patience with the constant complaints of pain sufferers. Doctors tend to throw up their hands, referring patients for psychotherapy or dismissing them as drug seekers trying to get opioids.
“Most people with chronic pain are still being treated as if pain is a symptom of an underlying problem,” said Melanie Thernstrom, a chronic pain sufferer from Vancouver, Wash., who wrote “The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing and the Science of Suffering” (Farrar, Straus & Giroux, 2010) and was a patient representative on the committee.
“If the doctor can’t figure out what the underlying problem is,” she went on, “then the pain is not treated, it’s dismissed and the patient falls down the rabbit hole.”
Among the important findings in the Institute of Medicine report is that chronic pain often outlasts the original illness or injury, causing changes in the nervous system that worsen over time. Doctors often cannot find an underlying cause because there isn’t one. Chronic pain becomes its own disease.
“When pain becomes chronic, when it becomes persistent even after the tissue and injury have healed, then people are suffering from chronic pain,” Dr. Mackey said. “We’re finding that there are significant changes in the central nervous system and spinal cord that cause pain to become amplified and persistent even after the injury has gone away.”
The institute emphasized the importance of prevention and early treatment, a novel concept for many doctors who try to diagnose the source of pain before treating it or advise patients to wait it out in the hope it will go away on its own.
“Having pain that is not treated is like having diabetes that’s not treated,” said Ms. Thernstrom, who suffers from spinal stenosis and a form of arthritis in the neck. “It gets worse over time.”
Ms. Thernstrom compared the effect of chronic pain on the body to the rushing waters of a river carving out a new tributary. Pain, she says, also changes the body’s landscape.
“My pain is at the level where it’s manageable,” she said. “I do wish I had gotten aggressive treatment in the first year. There is a window of time to intervene, because pain changes your nervous system and pain pathways develop.”
The report also acknowledged the “conundrum of opioids,” noting that doctors are conflicted about how to treat pain because of worries about drug addiction. But the group noted that proper use of the drugs early in a pain cycle can resolve pain problems sooner, and stated that opioids are also particularly useful for pain management near the end of life.
The pain report is only a first step for the community of medical professionals who treat pain. It will be up to medical schools to begin better education of doctors in the treatment of pain, and the National Institutes of Health to decide whether to promote research into chronic pain. Patients, too, need to be educated about the importance of early treatment of pain rather than gutting it out or waiting until it has become severe and chronic.
“Some people were expecting a cure within the report,” Dr. Mackey said. “There’s no immediate cure. But I’ve seen a lot of patients who have said, ‘Finally they are putting out a report that helps others understand what I’m going through.’ ”
In Rating Pain, Women Are the More Sensitive Sex
In Rating Pain, Women Are the More Sensitive Sex
Do women feel more pain than men?
It has long been known that certain pain-related conditions, like fibromyalgia, migraine and irritable bowel syndrome, are more common in women than in men. And chronic pain after childbirth is surprisingly common; the Institute of Medicine recently found that 18 percent of women who have Caesarean deliveries and 10 percent who have vaginal deliveries report still being in pain a year later.
But new research from Stanford University suggests that even when men and women have the same condition — whether it’s a back problem, arthritis or a sinus infection — women appear to suffer more from the pain.
There is an epidemic of chronic pain: Last year, the Institute of Medicine estimated that it afflicts 116 million Americans, far more than previously believed. But these latest findings, believed to be the largest study ever to compare pain levels in men and women, raise new questions about whether women are shouldering a disproportionate burden of chronic pain and suggest a need for more gender-specific pain research.
The study, published Monday in The Journal of Pain, analyzes data from the electronic medical records of 11,000 patients whose pain scores were recorded as a routine part of their care. (To obtain pain scores, doctors ask patients to describe their pain on a scale from 0, for no pain, to 10, “worst pain imaginable.”)
For 21 of 22 ailments with sample sizes large enough to make a meaningful comparison, the researchers found that women reported higher levels of pain than men. For back pain, women reported a score of 6.03, men 5.53. For joint and inflammatory pain, it was women 6.00, men 4.93. Women reported significantly higher pain levels with diabetes, hypertension, ankle injuries and even sinus infections.
For several diagnoses, women’s average pain score was at least one point higher than men’s, which is considered a clinically meaningful difference. Over all, their pain levels were about 20 percent higher than men’s.
Unfortunately, the data don’t offer any clues as to why women report higher pain levels. One possibility is that men have been socialized to be more stoic, so they underreport pain. But the study’s senior author, Dr. Atul Butte, an associate professor at Stanford’s medical school, said that explanation probably did not account for the gender gap.
“While you can imagine such a bias,” he said, “across studies, across thousands of patients, it’s hard to believe men are like this. You have to think about biological causes for the difference.”
An extensive 2007 report by the International Association for the Study of Pain cited studies showing that sex hormones may play a role in pain response. In fact, some of the gender differences, particularly regarding headache and abdominal pain, begin to diminish after women reach menopause.
Research also suggests that men and women have different responses to anesthesia and pain drugs, reporting different levels of efficacy and side effects. That bolsters the idea that men and women experience pain differently.
One reason for the lack of information about sex differences is that many pain studies, in both animals and humans, are done only in males. One analysis found that 79 percent of the animal studies published in a pain journal over a decade included only male subjects, compared with 8 percent that used only female animals.
In addition, experiments testing pain in men and women have shown that they typically have different thresholds for various types of pain. In general, women report higher levels of pain from pressure and electrical stimulation, and less pain when the source is from heat.
Melanie Thernstrom, a patient representative on the Institute of Medicine pain committee from Vancouver, Wash., said the newest research “really highlights the need for more treatment and better treatment that is gender-specific, and the need for far more research to really understand why women’s brains process pain differently than men.”
Some researchers believe the pain experience for women may be even more complicated. Women who have given birth, for instance, may have a different threshold for “worst pain ever,” causing them to underreport certain types of pain. The bottom line, Dr. Butte said, is that far too little is known about how men and women experience pain and that more study is needed so that, ultimately, pain treatment can be customized to each patient’s needs.
“If doctors have a threshold for when they give a dose or start a medication,” he said, “you could imagine that the number they are using is too high or too low because a person may be in more pain than they are saying.
“In the end, it comes down to what the brain perceives as pain.”
Do women feel more pain than men?
It has long been known that certain pain-related conditions, like fibromyalgia, migraine and irritable bowel syndrome, are more common in women than in men. And chronic pain after childbirth is surprisingly common; the Institute of Medicine recently found that 18 percent of women who have Caesarean deliveries and 10 percent who have vaginal deliveries report still being in pain a year later.
But new research from Stanford University suggests that even when men and women have the same condition — whether it’s a back problem, arthritis or a sinus infection — women appear to suffer more from the pain.
There is an epidemic of chronic pain: Last year, the Institute of Medicine estimated that it afflicts 116 million Americans, far more than previously believed. But these latest findings, believed to be the largest study ever to compare pain levels in men and women, raise new questions about whether women are shouldering a disproportionate burden of chronic pain and suggest a need for more gender-specific pain research.
The study, published Monday in The Journal of Pain, analyzes data from the electronic medical records of 11,000 patients whose pain scores were recorded as a routine part of their care. (To obtain pain scores, doctors ask patients to describe their pain on a scale from 0, for no pain, to 10, “worst pain imaginable.”)
For 21 of 22 ailments with sample sizes large enough to make a meaningful comparison, the researchers found that women reported higher levels of pain than men. For back pain, women reported a score of 6.03, men 5.53. For joint and inflammatory pain, it was women 6.00, men 4.93. Women reported significantly higher pain levels with diabetes, hypertension, ankle injuries and even sinus infections.
For several diagnoses, women’s average pain score was at least one point higher than men’s, which is considered a clinically meaningful difference. Over all, their pain levels were about 20 percent higher than men’s.
Unfortunately, the data don’t offer any clues as to why women report higher pain levels. One possibility is that men have been socialized to be more stoic, so they underreport pain. But the study’s senior author, Dr. Atul Butte, an associate professor at Stanford’s medical school, said that explanation probably did not account for the gender gap.
“While you can imagine such a bias,” he said, “across studies, across thousands of patients, it’s hard to believe men are like this. You have to think about biological causes for the difference.”
An extensive 2007 report by the International Association for the Study of Pain cited studies showing that sex hormones may play a role in pain response. In fact, some of the gender differences, particularly regarding headache and abdominal pain, begin to diminish after women reach menopause.
Research also suggests that men and women have different responses to anesthesia and pain drugs, reporting different levels of efficacy and side effects. That bolsters the idea that men and women experience pain differently.
One reason for the lack of information about sex differences is that many pain studies, in both animals and humans, are done only in males. One analysis found that 79 percent of the animal studies published in a pain journal over a decade included only male subjects, compared with 8 percent that used only female animals.
In addition, experiments testing pain in men and women have shown that they typically have different thresholds for various types of pain. In general, women report higher levels of pain from pressure and electrical stimulation, and less pain when the source is from heat.
Melanie Thernstrom, a patient representative on the Institute of Medicine pain committee from Vancouver, Wash., said the newest research “really highlights the need for more treatment and better treatment that is gender-specific, and the need for far more research to really understand why women’s brains process pain differently than men.”
Some researchers believe the pain experience for women may be even more complicated. Women who have given birth, for instance, may have a different threshold for “worst pain ever,” causing them to underreport certain types of pain. The bottom line, Dr. Butte said, is that far too little is known about how men and women experience pain and that more study is needed so that, ultimately, pain treatment can be customized to each patient’s needs.
“If doctors have a threshold for when they give a dose or start a medication,” he said, “you could imagine that the number they are using is too high or too low because a person may be in more pain than they are saying.
“In the end, it comes down to what the brain perceives as pain.”
Men Struggle for Rape Awareness
Men Struggle for Rape Awareness
Keith Smith was 14 when he was raped by a driver who picked him up after a hockey team meeting. He had hitchhiked home, which is why, for decades, he continued to blame himself for the assault.
When the driver barreled past Hartley’s Pork Pies on the outskirts of Providence, R.I., where Mr. Smith had asked to be dropped off, and then past a firehouse, he knew something was wrong.
“I tried to open the car door, but he had rigged the lock,” said Mr. Smith, of East Windsor, N.J., now 52. Still, he said, “I had no idea it was going to be a sexual assault.”
Even today, years after the disclosure of the still-unfolding child abuse scandal in the Catholic Church and the arrest of a former Pennsylvania State University assistant football coach accused of sexually abusing boys, rape is widely thought of as a crime against women.
Until just a few weeks ago, when the federal government expanded its definition of rape to include a wider range of sexual assaults, national crime statistics on rape included only assaults against women and girls committed by men under a narrow set of circumstances. Now they will also include male victims.
While most experts agree women are raped far more often than men, 1.4 percent of men in a recent national survey said they had been raped at some point. The study, by the Centers for Disease Control and Prevention, found that when rape was defined as oral or anal penetration, one in 71 men said they had been raped or had been the target of attempted rape, usually by a man they knew. (The study did not include men in prison.)
And one in 21 said they had been forced to penetrate an acquaintance or a partner, usually a woman; had been the victim of an attempt to force penetration; or had been made to receive oral sex.
Other estimates have run even higher. A Department of Justice report found that 3 percent of men, or one in 33, had been raped. Some experts believe that one in six men have experienced unwanted sexual contact of some kind as minors.
But for many men, the subject is so discomfiting that it is rarely discussed — virtually taboo, experts say, because of societal notions about masculinity and the idea that men are invulnerable and can take care of themselves.
“We have a cultural blind spot about this,” said David Lisak, a clinical psychologist who has done research on interpersonal violence and sexual abuse and is a founding board member of 1in6, an organization that offers information and services to men who had unwanted or abusive sexual experiences as children.
“We recognize that male children are being abused,” Dr. Lisak said, “but then when boys cross some kind of threshold somewhere in adolescence and become what we perceive to be men, we no longer want to think about it in this way.”
Even when high-profile cases dominate the news, said Mai Fernandez, executive director of the National Center for Victims of Crime advocacy organization in Washington, “attention goes to the things we feel more comfortable talking about — such as whether Penn State had done enough, and what will happen to their football program — and not to the question, ‘What do we do to prevent boys from being sexually assaulted?’ ”
In an interview with The Washington Post this month, Joe Paterno, the Penn State football coach who was fired after the abuse scandal erupted and who died of lung cancer on Sunday, said that when an assistant had told him about witnessing an inappropriate encounter between a young boy and Jerry Sandusky, the former assistant coach who is facing charges of sexual abuse, he had been confused and unsure how to proceed. Mr. Paterno said the assistant “didn’t want to get specific. And to be frank with you, I don’t know that it would have done any good, because I never heard of, of rape and a man.”
Much of the research on the sexual assault of men has focused on prisons. But men are also raped outside of prison, usually by people they know, including acquaintances and intimate partners, but occasionally by complete strangers. They are raped as part of violent, drunken or drug-induced assaults; war crimes; interrogations; antigay bias crimes; and hazing rites for male clubs and organizations, like fraternities, and in the military.
In one study of 3,337 military veterans applying for disability benefits for post-traumatic stress disorder, 6.5 percent of male combat veterans and 16.5 percent of noncombat veterans reported either in-service or post-service sexual assault. (The rates were far higher for female veterans, 69.0 percent and 86.6 percent respectively.)
A Pentagon report released on Thursday found a 64 percent increase in sexual crimes in the Army since 2006, with rape, sexual assault and forcible sodomy the most frequent violent sex crimes committed last year; 95 percent of all victims were women.
Some studies have reported that the risk of rape is greatest for men who are young, are living in poverty or homeless, or are disabled or mentally ill. The C.D.C. study found that one-quarter of men who had been raped were assaulted before they were 10 , usually by someone they knew.
And young men raised by poor single mothers are especially vulnerable to male predators, said Dr. Zane Gates, an internist who cares for low-income patients on Medicaid at a community health center in Altoona, Pa.
“You’re looking for a male figure in your life desperately, and you’ll give anything for that,” he said.
Keith Smith was 14 when he was raped by a driver who picked him up after a hockey team meeting. He had hitchhiked home, which is why, for decades, he continued to blame himself for the assault.
When the driver barreled past Hartley’s Pork Pies on the outskirts of Providence, R.I., where Mr. Smith had asked to be dropped off, and then past a firehouse, he knew something was wrong.
“I tried to open the car door, but he had rigged the lock,” said Mr. Smith, of East Windsor, N.J., now 52. Still, he said, “I had no idea it was going to be a sexual assault.”
Even today, years after the disclosure of the still-unfolding child abuse scandal in the Catholic Church and the arrest of a former Pennsylvania State University assistant football coach accused of sexually abusing boys, rape is widely thought of as a crime against women.
Until just a few weeks ago, when the federal government expanded its definition of rape to include a wider range of sexual assaults, national crime statistics on rape included only assaults against women and girls committed by men under a narrow set of circumstances. Now they will also include male victims.
While most experts agree women are raped far more often than men, 1.4 percent of men in a recent national survey said they had been raped at some point. The study, by the Centers for Disease Control and Prevention, found that when rape was defined as oral or anal penetration, one in 71 men said they had been raped or had been the target of attempted rape, usually by a man they knew. (The study did not include men in prison.)
And one in 21 said they had been forced to penetrate an acquaintance or a partner, usually a woman; had been the victim of an attempt to force penetration; or had been made to receive oral sex.
Other estimates have run even higher. A Department of Justice report found that 3 percent of men, or one in 33, had been raped. Some experts believe that one in six men have experienced unwanted sexual contact of some kind as minors.
But for many men, the subject is so discomfiting that it is rarely discussed — virtually taboo, experts say, because of societal notions about masculinity and the idea that men are invulnerable and can take care of themselves.
“We have a cultural blind spot about this,” said David Lisak, a clinical psychologist who has done research on interpersonal violence and sexual abuse and is a founding board member of 1in6, an organization that offers information and services to men who had unwanted or abusive sexual experiences as children.
“We recognize that male children are being abused,” Dr. Lisak said, “but then when boys cross some kind of threshold somewhere in adolescence and become what we perceive to be men, we no longer want to think about it in this way.”
Even when high-profile cases dominate the news, said Mai Fernandez, executive director of the National Center for Victims of Crime advocacy organization in Washington, “attention goes to the things we feel more comfortable talking about — such as whether Penn State had done enough, and what will happen to their football program — and not to the question, ‘What do we do to prevent boys from being sexually assaulted?’ ”
In an interview with The Washington Post this month, Joe Paterno, the Penn State football coach who was fired after the abuse scandal erupted and who died of lung cancer on Sunday, said that when an assistant had told him about witnessing an inappropriate encounter between a young boy and Jerry Sandusky, the former assistant coach who is facing charges of sexual abuse, he had been confused and unsure how to proceed. Mr. Paterno said the assistant “didn’t want to get specific. And to be frank with you, I don’t know that it would have done any good, because I never heard of, of rape and a man.”
Much of the research on the sexual assault of men has focused on prisons. But men are also raped outside of prison, usually by people they know, including acquaintances and intimate partners, but occasionally by complete strangers. They are raped as part of violent, drunken or drug-induced assaults; war crimes; interrogations; antigay bias crimes; and hazing rites for male clubs and organizations, like fraternities, and in the military.
In one study of 3,337 military veterans applying for disability benefits for post-traumatic stress disorder, 6.5 percent of male combat veterans and 16.5 percent of noncombat veterans reported either in-service or post-service sexual assault. (The rates were far higher for female veterans, 69.0 percent and 86.6 percent respectively.)
A Pentagon report released on Thursday found a 64 percent increase in sexual crimes in the Army since 2006, with rape, sexual assault and forcible sodomy the most frequent violent sex crimes committed last year; 95 percent of all victims were women.
Some studies have reported that the risk of rape is greatest for men who are young, are living in poverty or homeless, or are disabled or mentally ill. The C.D.C. study found that one-quarter of men who had been raped were assaulted before they were 10 , usually by someone they knew.
And young men raised by poor single mothers are especially vulnerable to male predators, said Dr. Zane Gates, an internist who cares for low-income patients on Medicaid at a community health center in Altoona, Pa.
“You’re looking for a male figure in your life desperately, and you’ll give anything for that,” he said.
Chaotic Start to Egypt’s First Democratically Elected Parliament
Chaotic Start to Egypt’s First Democratically Elected Parliament
CAIRO — As Egypt’s first freely elected Parliament in six decades held its opening session on Monday, the Muslim Brotherhood received a lesson in the unwieldiness of democracy when a dispute over choosing a speaker degenerated into a shouting match that overshadowed the day.
It took until nightfall for the Muslim Brotherhood to decisively beat back the challenge to its choice of Saad el-Katatni, a Brotherhood stalwart, by a vote of nearly 400 to fewer than 100.
Its victory was another marker in the group’s transformation from outlawed opposition to political establishment. The Brotherhood won nearly half the legislative seats during the first free elections since last year’s ouster of Hosni Mubarak. After struggling for 84 years in the shadows of monarchy and dictatorship, the Brotherhood — the secretive, hierarchical once-militant group that became the fountainhead of Islamist ideologies — gained political power and the hope of democratic legitimacy as a result of Monday’s vote.
Its triumph, in the heart of the Arab world and the center of last year’s regional uprising, was arguably the closest that Islamists have ever come to governing an Arab country since their movement was born here 80 years ago. Although a party with Islamist roots dominated Tunisia’s elections last fall, it has sought to jettison the label in order to emphasize its commitment to democracy and pluralism, while the Brotherhood still considers itself the movement’s flagship.
In a weary speech after his election late Monday night, Mr. Katatni said the differences of opinion expressed over his selection were democracy in action. “This is democracy that had left this hall for years, and now the people have grasped it,” he said. “We want Egypt and the whole world to know that our revolution will continue and we will not rest and our eyes won’t sleep until the revolution fulfills all its demands.”
But the acrimony of the challenge to Mr. Katatni from a former Brotherhood leader was also a reminder of the difficulties facing the group as it tries to unite the country, the Parliament and even its fellow Islamists, especially at a time when Egypt remains under the rule of the generals who seized power from Mr. Mubarak.
The bedlam in the chamber tempered a day that had begun as a joyous occasion for some Brotherhood members. Hundreds of them arrived outside the Parliament in the early morning, directed by their leaders both to cheer for the new lawmakers and to ensure against any outbreak of violence. “Everyone has his role to play,” said Mohsen Eid, 44, an aviation engineer and Brotherhood member.
For many, it was the first opportunity to recognize an achievement three generations in the making. “This is the most important day in our lives, after the day Mubarak left,” said Abdul Moneim el-Tantawy, 67, a mechanical engineer. “This is our celebration,” he said, looking up at the Parliament building. “Before, if we stood here, we would be taken directly to jail.”
Men held hands and danced in the street, singing religious and patriotic songs. They carried paunchy middle-aged men in suits and ties on their shoulders to lead them in chants like a high school sports team that won a big game. Some handed the lawmakers flowers as they approached the door, and a few men and women cried tears of joy.
Some members of Parliament tried to approach by car but the crowds were so thick they had to get out and walk. “At this time there is no one who can overcome the people,” said Ahmed Hassanin, 41, a neurologist who turned up before 8 a.m. to watch the lawmakers arrive for the historic session. “It was beautiful.”
The streets around the Parliament had been repainted, to hide the evidence of the deadly clashes between security forces and protesters challenging military rule that took place there just a month before. But by midafternoon a few thousand other demonstrators had arrived, many repeating the demand for the military rulers to step down immediately — a call the Muslim Brotherhood has not endorsed. It has accepted the military’s plan to hand over power to a newly elected president by the end of June.
CAIRO — As Egypt’s first freely elected Parliament in six decades held its opening session on Monday, the Muslim Brotherhood received a lesson in the unwieldiness of democracy when a dispute over choosing a speaker degenerated into a shouting match that overshadowed the day.
It took until nightfall for the Muslim Brotherhood to decisively beat back the challenge to its choice of Saad el-Katatni, a Brotherhood stalwart, by a vote of nearly 400 to fewer than 100.
Its victory was another marker in the group’s transformation from outlawed opposition to political establishment. The Brotherhood won nearly half the legislative seats during the first free elections since last year’s ouster of Hosni Mubarak. After struggling for 84 years in the shadows of monarchy and dictatorship, the Brotherhood — the secretive, hierarchical once-militant group that became the fountainhead of Islamist ideologies — gained political power and the hope of democratic legitimacy as a result of Monday’s vote.
Its triumph, in the heart of the Arab world and the center of last year’s regional uprising, was arguably the closest that Islamists have ever come to governing an Arab country since their movement was born here 80 years ago. Although a party with Islamist roots dominated Tunisia’s elections last fall, it has sought to jettison the label in order to emphasize its commitment to democracy and pluralism, while the Brotherhood still considers itself the movement’s flagship.
In a weary speech after his election late Monday night, Mr. Katatni said the differences of opinion expressed over his selection were democracy in action. “This is democracy that had left this hall for years, and now the people have grasped it,” he said. “We want Egypt and the whole world to know that our revolution will continue and we will not rest and our eyes won’t sleep until the revolution fulfills all its demands.”
But the acrimony of the challenge to Mr. Katatni from a former Brotherhood leader was also a reminder of the difficulties facing the group as it tries to unite the country, the Parliament and even its fellow Islamists, especially at a time when Egypt remains under the rule of the generals who seized power from Mr. Mubarak.
The bedlam in the chamber tempered a day that had begun as a joyous occasion for some Brotherhood members. Hundreds of them arrived outside the Parliament in the early morning, directed by their leaders both to cheer for the new lawmakers and to ensure against any outbreak of violence. “Everyone has his role to play,” said Mohsen Eid, 44, an aviation engineer and Brotherhood member.
For many, it was the first opportunity to recognize an achievement three generations in the making. “This is the most important day in our lives, after the day Mubarak left,” said Abdul Moneim el-Tantawy, 67, a mechanical engineer. “This is our celebration,” he said, looking up at the Parliament building. “Before, if we stood here, we would be taken directly to jail.”
Men held hands and danced in the street, singing religious and patriotic songs. They carried paunchy middle-aged men in suits and ties on their shoulders to lead them in chants like a high school sports team that won a big game. Some handed the lawmakers flowers as they approached the door, and a few men and women cried tears of joy.
Some members of Parliament tried to approach by car but the crowds were so thick they had to get out and walk. “At this time there is no one who can overcome the people,” said Ahmed Hassanin, 41, a neurologist who turned up before 8 a.m. to watch the lawmakers arrive for the historic session. “It was beautiful.”
The streets around the Parliament had been repainted, to hide the evidence of the deadly clashes between security forces and protesters challenging military rule that took place there just a month before. But by midafternoon a few thousand other demonstrators had arrived, many repeating the demand for the military rulers to step down immediately — a call the Muslim Brotherhood has not endorsed. It has accepted the military’s plan to hand over power to a newly elected president by the end of June.
Saturday, January 21, 2012
Lechery, Immodesty and the Talmud
IS it possible for a religious demand for modesty to be about anything other than men controlling women’s bodies? From recent events in Israel, it would certainly seem that it is not.
Last month, an innocent, modestly dressed 8-year-old girl, Naama Margolese, living in Beit Shemesh, described being spat on and vilified by religious extremists — all men — who believed that she did not dress modestly enough while walking past them to the religious school she attends. And more and more, public buses in Israel are enforcing gender segregation imposed by ultra-Orthodox riders in and near their neighborhoods. Woe to the girl or woman who refuses to move to the back of the bus.
This is part of a larger battle being waged in Israel between the ultra-Orthodox and the rest of Israeli society over women’s place in society, over their very right to have a visible presence and to participate in the public sphere.
What is behind these deeply disturbing events? We are told that they arise from a religious concern about modesty, that women must be covered and sequestered so that men do not have improper sexual thoughts. It seems, then, that a religious tenet that begins with men’s sexual thoughts ends with men controlling women’s bodies.
This is not a problem unique to Judaism. But the Talmud, the basis for Jewish law, offers a perhaps surprising answer: It places the responsibility for controlling men’s licentious thoughts about women squarely on the men.
Put more plainly, the Talmud says: It’s your problem, sir; not hers.
The ultra-Orthodox men in Israel who are exerting control over women claim that they are honoring women. In effect they are saying: We do not treat women as sex objects as you in Western society do. Our women are about more than their bodies, and that is why their bodies must be fully covered.
In fact, though, their actions objectify and hyper-sexualize women. Think about it: By saying that all women must hide their bodies, they are saying that every woman is an object who can stir a man’s sexual thoughts. Thus, every woman who passes their field of vision is sized up on the basis of how much of her body is covered. She is not seen as a complete person, only as a potential inducement to sin.
Of course, once you judge a female human being only through a man’s sexualized imagination, you can turn even a modest 8-year-old girl into a seductress and a prostitute.
At heart, we are talking about a blame-the-victim mentality. It shifts the responsibility of managing a man’s sexual urges from himself to every woman he may or may not encounter. It is a cousin to the mentality behind the claim, “She was asking for it.”
So the responsibility is now on the women. To protect men from their sexual thoughts, women must remove their femininity from their public presence, ridding themselves of even the smallest evidence of their own sexuality.
All of this is done in the name of the Torah and Jewish law.
But it’s actually a complete perversion. The Talmud, the foundation of Jewish law, acknowledges that men can be sexually aroused by women and is indeed concerned with sexual thoughts and activity outside of marriage. But it does not tell women that men’s sexual urges are their responsibility. Rather, both the Talmud and the later codes of Jewish law make that demand of men.
It is forbidden for a man to gaze sexually at a woman, whether beautiful or ugly, married or unmarried, says the Talmud. Later Talmudic rabbis extended this ban even to “her smallest finger” and “her brightly colored clothing — even if they are drying on the wall.”
To make these the woman’s responsibility is to demand that Jewish women cover their hands, and that they not dry their clothes in public. No one has ever said this. At least not yet.
The Talmud tells the religious man, in effect: If you have a problem, you deal with it. It is the male gaze — the way men look at women — that needs to be desexualized, not women in public. The power to make sure men don’t see women as objects of sexual gratification lies within men’s — and only men’s — control.
Jewish tradition teaches men and women alike that they should be modest in their dress. But modesty is not defined by, or even primarily about, how much of one’s body is covered. It is about comportment and behavior. It is about recognizing that one need not be the center of attention. It is about embodying the prophet Micah’s call for modesty: learning “to walk humbly with your God.”
Eight-year-old Naama could teach her attackers a thing or two about modesty.
Dov Linzer, an Orthodox rabbi, is the dean of Yeshivat Chovevei Torah Rabbinical School in the Riverdale section of the Bronx.
Last month, an innocent, modestly dressed 8-year-old girl, Naama Margolese, living in Beit Shemesh, described being spat on and vilified by religious extremists — all men — who believed that she did not dress modestly enough while walking past them to the religious school she attends. And more and more, public buses in Israel are enforcing gender segregation imposed by ultra-Orthodox riders in and near their neighborhoods. Woe to the girl or woman who refuses to move to the back of the bus.
This is part of a larger battle being waged in Israel between the ultra-Orthodox and the rest of Israeli society over women’s place in society, over their very right to have a visible presence and to participate in the public sphere.
What is behind these deeply disturbing events? We are told that they arise from a religious concern about modesty, that women must be covered and sequestered so that men do not have improper sexual thoughts. It seems, then, that a religious tenet that begins with men’s sexual thoughts ends with men controlling women’s bodies.
This is not a problem unique to Judaism. But the Talmud, the basis for Jewish law, offers a perhaps surprising answer: It places the responsibility for controlling men’s licentious thoughts about women squarely on the men.
Put more plainly, the Talmud says: It’s your problem, sir; not hers.
The ultra-Orthodox men in Israel who are exerting control over women claim that they are honoring women. In effect they are saying: We do not treat women as sex objects as you in Western society do. Our women are about more than their bodies, and that is why their bodies must be fully covered.
In fact, though, their actions objectify and hyper-sexualize women. Think about it: By saying that all women must hide their bodies, they are saying that every woman is an object who can stir a man’s sexual thoughts. Thus, every woman who passes their field of vision is sized up on the basis of how much of her body is covered. She is not seen as a complete person, only as a potential inducement to sin.
Of course, once you judge a female human being only through a man’s sexualized imagination, you can turn even a modest 8-year-old girl into a seductress and a prostitute.
At heart, we are talking about a blame-the-victim mentality. It shifts the responsibility of managing a man’s sexual urges from himself to every woman he may or may not encounter. It is a cousin to the mentality behind the claim, “She was asking for it.”
So the responsibility is now on the women. To protect men from their sexual thoughts, women must remove their femininity from their public presence, ridding themselves of even the smallest evidence of their own sexuality.
All of this is done in the name of the Torah and Jewish law.
But it’s actually a complete perversion. The Talmud, the foundation of Jewish law, acknowledges that men can be sexually aroused by women and is indeed concerned with sexual thoughts and activity outside of marriage. But it does not tell women that men’s sexual urges are their responsibility. Rather, both the Talmud and the later codes of Jewish law make that demand of men.
It is forbidden for a man to gaze sexually at a woman, whether beautiful or ugly, married or unmarried, says the Talmud. Later Talmudic rabbis extended this ban even to “her smallest finger” and “her brightly colored clothing — even if they are drying on the wall.”
To make these the woman’s responsibility is to demand that Jewish women cover their hands, and that they not dry their clothes in public. No one has ever said this. At least not yet.
The Talmud tells the religious man, in effect: If you have a problem, you deal with it. It is the male gaze — the way men look at women — that needs to be desexualized, not women in public. The power to make sure men don’t see women as objects of sexual gratification lies within men’s — and only men’s — control.
Jewish tradition teaches men and women alike that they should be modest in their dress. But modesty is not defined by, or even primarily about, how much of one’s body is covered. It is about comportment and behavior. It is about recognizing that one need not be the center of attention. It is about embodying the prophet Micah’s call for modesty: learning “to walk humbly with your God.”
Eight-year-old Naama could teach her attackers a thing or two about modesty.
Dov Linzer, an Orthodox rabbi, is the dean of Yeshivat Chovevei Torah Rabbinical School in the Riverdale section of the Bronx.
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